Ten patients with gliomas were treated between 1977 and 1993. Three of the lesions (30 percent) exhibited intracranial extension. Fifty percent (2 of 4) of the intranasal lesions exhibited intracranial extension. Effective removal of the lesion required manipulation of nasal bones in intranasal lesions and extranasal lesions with intranasal extension. Gliomas with an intracranial component were best addressed through a combined intracranial and extracranial approach.